Association of Cigarette Smoking and Alcohol Drinking With Risk of 12 Common Cancers Among Low-Income American Adults in the Southeastern United States

Q: What was the study aiming to determine?

To determine a comprehensive cancer risk profile associated with cigarette smoking and alcohol drinking across twelve cancer types in predominantly low-income Americans.

Q: How was the study conducted?

Associations between smoking, alcohol intake, and cancer risk were investigated prospectively in over 74,000 low-income Black and White adults using Cox proportional hazards models.

Q: Which cancers showed increased risk with current smoking and with alcohol intake?

Current smokers had increased risks for multiple cancers including lung, liver and bile duct, oral and pharynx, and bladder, while alcohol intake above two drinks per day increased risks for liver and bile duct and oral and pharynx cancers.

Sep 23, 2026

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Cigarette smoking and alcohol drinking are established cancer risk factors, yet a comprehensive risk profile across multiple cancer types in low-income populations remains limited. This study prospectively examined associations between smoking and alcohol intake and the risk of twelve cancers among more than 74,000 low-income Black and White adults in the Southern Community Cohort Study. Cox proportional hazards models estimated hazard ratios with 95% confidence intervals. Current smoking increased risk for several cancers, with strong elevations for lung cancer, while alcohol intake exceeding two drinks per day increased risks for liver and bile duct and oral and pharynx cancers.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

Smoking and cancer risk

Alcohol and combined effects

Evidence gaps in prior studies

Methods

Results

Conclusion

Moving toward equity: Identifying and mitigating disparities in cancer care from screening to survival-Research article Association of Cigarette Smoking and Alcohol Drinking With Risk of 12 Common Cancers Among Low-Income American Adults in the Southeastern United States Cancer Control Volume 32: 1–10 © The Author(s) 2025 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/10732748251341523](DOI: 10.1177/10732748251341523) [journals.sagepub.com/home/ccx](journals.sagepub.com/home/ccx) Jiajun Shi, PhD 1 􀀁, Wanqing Wen, MD, MPH1,2, Qiuyin Cai, MD, PhD 1,2, Martha J. Shrubsole, PhD 1, Xiao-Ou Shu, MD, PhD 1,2, and Wei Zheng, MD, PhD 1,2 Abstract Introduction: Cigarette smoking and alcohol drinking are well-known risk factors for various cancers. We aimed to determine a comprehensive proﬁle of cancer risk associated with these lifestyle factors in predominantly low-income Americans. Methods: We prospectively investigated the associations between cigarette smoking, alcohol drinking, and the risk of twelve cancer types among over 74 000 low-income Black and White adults from the Southern Community Cohort Study in the United States. We used the Cox proportional hazards models to estimate the hazard ratios (HRs) and corresponding 95% conﬁdence intervals (CIs) for these associations. Results: Compared to never smokers, current smokers had an increased HR for cancers of lung (HR: 14.14, 95% CI: 11.47- 17.42), liver and bile duct (HR: 3.19, 95% CI: 2.40-4.25), kidney (HR: 1.47, 95% CI: 1.10-1.96), pancreas (HR: 1.88, 95% CI: 1.41- 2.50), oral and pharynx (HR: 3.83, 95% CI: 2.70-5.42), and bladder (HR: 2.81, 95% CI: 1.92-4.11), and a reduced risk of prostate cancer (HR: 0.78, 95% CI: 0.68-0.89) and uterine cancer (HR: 0.45, 95% CI: 0.32-0.63); former smokers also exhibited elevated risks for cancers of lung, liver and bile duct, kidney, and bladder; however, a decreased risk for the lung, liver and bile duct, and bladder cancers was observed with longer durations of smoking cessation, with HRs from 9.71, 2.26, and 2.28 for a duration of <10 years down to 4.28, 1.58, and 1.42 for a duration of 10-19 years, respectively. Compared to never-drinkers, participants who consumed more than 2 drinks per day had increased risks of liver and bile duct cancer (HR: 1.66, 95% CI: 1.29-2.13) and oral and pharynx cancer (HR: 2.15, 95% CI: 1.58-2.91). Conclusion: Cigarette smoking and alcohol drinking were associated with an increased risk of multiple cancers. Our ﬁndings support efforts to control cigarette and alcohol consumption for cancer prevention in low-income U.S. populations. Keywords cigarette smoking, alcohol drinking, cancer risk, cohort study, Black and White Americans Received: 19 February 2025; revised: 15 April 2025; accepted: 24 April 2025. 1 Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA 2Division of Epidemiology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN, USA Corresponding Author: Wanqing Wen, MD, Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 1440, Nashville, TN 37203, USA. [Email:](Email: wanqing.wen@vanderbilt.edu)[ wanqing.wen@vanderbilt.edu](Email: wanqing.wen@vanderbilt.edu) Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as speciﬁed on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](htt

FAQs

What was the study aiming to determine?

To determine a comprehensive cancer risk profile associated with cigarette smoking and alcohol drinking across twelve cancer types in predominantly low-income Americans.

How was the study conducted?

Associations between smoking, alcohol intake, and cancer risk were investigated prospectively in over 74,000 low-income Black and White adults using Cox proportional hazards models.

Which cancers showed increased risk with current smoking and with alcohol intake?

Current smokers had increased risks for multiple cancers including lung, liver and bile duct, oral and pharynx, and bladder, while alcohol intake above two drinks per day increased risks for liver and bile duct and oral and pharynx cancers.

Sep 23, 2026

Uploaded by Angel